Traumatic Conditions (Other): Slipped Upper Humeral Epiphysis

This is a child/adolescent injury, seen most often between the ages of 11 and 15 years. The majority are, in fact, Salter I or II fractures.

Occasionally an associated brachial plexus injury occurs. It may give the clinical appearance of anterior dislocation, but have a typical x-ray appearance.

Fig 1: Slipped upper humeral epiphysis (patient’s right) appearing as a dislocation	Fig 2: Slipped upper humeral epiphysis appearing as a dislocation (click on x-ray to enlarge)

Treatment

Treatment in children less than five years of age is generally conservative. However, in children from 5 to 12 years closed reduction may be required for significantly displaced or angulated fractures in children near the end of growth.

Operative treatment is rarely indicated. An injury associated with a neurovascular complication is an indication for surgical treatment.